Comprehensive sections explain the complexities of:
The 2-midnight benchmark and presumption
Coverage under NCDs, LCDs, and CED
Inpatient order requirements
Inpatient-only procedures, including changes for 2019
Outpatient coverage and physician supervision
Observation coverage, billing, and payment
Correct use of condition codes 44 and W2
NCCI edits, including PTP edits and MUEs
Payment under the OPPS and IPPS
Patient deductible and copayment amounts
ABNs, HINNs and billing non-covered services
Medicare websites and resources